When to Expect Accutane to Start Working?

Isotretinion takes 20+ weeks to fully work, its all dependent on the total dose used.  Most people see results in 6-8 weeks after starting and will see a flare of the acne at the beginning.  I have my patients do light chemical peels and skin care/facials during therapy.  If they have acne scars and facial redness, ill use pulsed dye laser and microneedling for improvement.  Best, Dr. Emer.

The first month on Isotretinoin can be challenging.  Things often get worse before they start to get better.  By the end of the second month there are usually no new breakouts and patients more often complain about redness & dryness than new pimples or painful cysts. 
 

Accutane does not start working immediately. In most cases, the first month your acne may be worse or may flare. After about 6 weeks is when I start seeing the major benefits from Accutane. It is important to be patient while on this medication. 

Accutane will usually start to work within the first 1-2 months, but some patients will actually worsen during this initial phase, and this is normal too. Each patient will have a different experience, and very few patients are still breaking out towards the end of their treatment. When a patient is still experiencing breakouts there are few options to what can be done: we can finish the 6 months, take a 3 month break, then resume another course, or we can extend the treatment beyond the 6 months (and this is dependent on you Doctor's clinical judgement), and we can consider other reasons for why a break out is still occurring, we should consider a hormonal component if the patient is female which can also be treated successfully.While on Accutane, I would only use gentle facial cleansers, avoid using any acne topical therapies, avoid supplemental Vitamin A, and use sun protection daily, and do not forget to use a good lip balm several times per day.Good luck, Dr. P.

In the first month of treatment on Accutane you may notice a worsening of acne. This is expected and it's really a function of Accutane causing "epidermal and sebaceous maturation". Most patients start to notice clearing about a month after starting Accutane and it continues through the course.
As far as preventative measures: make sure to use an oil-free non-comedogenic moisturizer and sunblock everyday along with emolliating lip balm such as Aquaphor. 
Good luck!